netilmicin and Chronic-Disease

Hemodiafiltration (HDF) is a new dialysis treatment that combines convective and diffusive forces. In order to assess the efficiency of a peculiar model of hypertonic HDF (H HDF), we studied eight uremic patients when they were undergoing five sessions of H HDF of 180 minutes duration and two sessions of standard hemodialysis (HD) of 270 minutes duration with a comparable blood (approximately 400 mL/min) and dialysate flow rate (approximately 520 mL/min). The plasma water clearances (Kw) of small [urea (U), creatinine (C), uric acid (UA), and phosphorus (P)] and middle molecules [netilmicin (N) and inulin (I)] were exceedingly higher in H HDF than in HD; however, because of the different treatment times, U and C removal (R) in HD overcame and UA and P R in HD equalized that in H HDF. The factor time was not sufficient to HD to compensate for the large difference in Kw in the case of I. Additional studies were performed in seven out of the eight patients after two sessions of H HDF and one session of HD. Two significantly higher rebounds were observed when comparing both treatments: for U after HD and for parathyroid hormone (PTH) after H HDF; however, PTH Cx/Cs ratios (ratios of the plasma water concentration of PTH at any postdialysis time to the plasma water concentration of PTH at the start of the run) were not different in both treatments, meaning that there was an increased PTH secretion in the early post H HDF hours in order to compensate for the larger PTH R with H HDF.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Blood; Chronic Disease; Creatinine; Female; Humans; Inulin; Kinetics; Male; Middle Aged; Models, Biological; Netilmicin; Parathyroid Hormone; Phosphorus; Renal Dialysis; Toxins, Biological; Ultrafiltration; Urea; Uremia; Uric Acid

A trial was conducted with long-term intermittent netilmicin therapy in six patients suffering from chronic pyelonephritis. Netilmicin was given in full dose for a period of 3-10 days (2-6 mg/kg/day), followed by 2 mg/kg doses once or twice weekly for 3-6 months. Individual doses were determined by computer based on the age, sex, lean body weight and serum creatinine concentrations of the patients. During the full-dose period of treatment netilmicin concentrations in serum were between 2 and 16 mg/l in serum and between 50 and 200 mg/l in urine. During intermittent treatment serum levels remained below 2 mg/l (except for 8-12 hours after dosing); in the urine concentrations were permanently in therapeutic ranges (150-4 mg/l). Renal tissue levels were simulated. Six to 12 months after long-term netilmicin treatment all patients are abacteriuric and free from symptoms. No auditory or renal toxic effects occurred.

Topics: Adult; Aged; Chromatography, High Pressure Liquid; Chronic Disease; Female; Gentamicins; Humans; Injections, Intramuscular; Kinetics; Male; Middle Aged; Netilmicin; Pyelonephritis

Daily 150 mg or 200 mg dose of netilmicin (NTL) were administered to 26 patients with chronic complicated urinary tract infections for 5 days, and the following results were obtained. 1) Out of 26 cases excellent response was seen in 5 cases, good response in 4, and poor response in 11. Effectiveness rate was 45%. Six cases were excluded from the evaluation. 2) Effective result was not seen in the catheterized group, whereas 5 excellent and 4 good cases were observed in the noncatheterized group, resulting 60% in effectiveness rate. 3) MICs of NTL against various bacteria were comparative to GM against P. aeruginosa, to AMK against Serratia, and to both GM and AMK against other bacteria. 4) Except a slight local irritation, no subjective side effect was observed. One case showed a slight elevation in hepatic function tests but it was not definitely judged as the side effect due to NTL.

Topics: Adult; Aged; Bacteria; Chronic Disease; Drug Evaluation; Drug Resistance, Microbial; Female; Gentamicins; Humans; Male; Middle Aged; Netilmicin; Urinary Tract Infections

Sixteen patients with chronic or recurrent urinary tract infections, 14 with septicaemia, 2 with salmonellosis, 2 with pneumonia and 1 with acute mastitis were treated with 200 mg (2.2-3.6 mg/kg) netilmicin intramuscularly every 8 hours for 7-10 days (mean 8.8 days). 28 patients were cured, 5 showed marked improvement and 2 patients with septicaemia and severe underlying diseases failed to respond to treatment. The bacterial isolates were inhibited by 4.0 mg netilmicin/l or less. Antibiotic serum level determinations were performed in 32 patients. Mean serum concentrations of netilmicin 1 and 8 hours after injection were 12.6 and 2.0 mg/l respectively in 27 patients with normal serum creatinine levels. In 5 patients with elevated serum creatinine, mean peak and trough values were 21.5 and 5.8 mg/l, respectively. Mean netilmicin concentrations in serum and skin blister fluid obtained from 4 patients were equal 2-3 hours after injection, indicating appropriate tissue penetration. Nephrotoxicity occurred in 2 patients. Ototoxicity was not demonstrated. Netilmicin appears to be an effective and safe drug in the treatment of a variety of bacterial infections.

Topics: Adult; Aged; Bacterial Infections; Chronic Disease; Creatinine; Drug Evaluation; Female; Gentamicins; Hearing; Humans; Male; Middle Aged; Netilmicin; Sepsis; Urinary Tract Infections